[New diagnostic frontiers in Brucellosis]

Because the symptoms and signs of Brucellosis are nonspecific the diagnosis is made with certainty by isolation of brucella or of its nucleic acids, or by evidence of a specific immunologic response. The rate of isolation from blood varies from 50 to 80% during the acute phase; bone marrow cultures may have a higher rate than blood in chronic disease. Recently, the isolation time for brucellae may be reduced by automated culture systems (e.g. the lysis-concentration technique or BACTEC) from weeks to days. Although a number of techniques have been developed to measure brucella antibodies (immunoenzymatic, immunofluorescent assays), the serum agglutination test is the simplest and most widely used. Recently, the Polymerase Chain Reaction has been used to evidence nucleic acids of brucella; although it shows high specificity and sensitivity, in the acute and chronic disease, and allows rapid diagnosis, standardization and further evaluation are needed.